Rest, take a deeper breath and let it go…

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These are words that I say hundreds of times per week while sitting with the traumatic or stressful memories of my clients.  The modality I mostly use to assist my clients is Eye Movement Desensitization and Reprocessing (EMDR). The goal of EMDR (or any trauma therapy) is completing the stress cycle and realizing that the traumatic or stressful event they experienced is over.

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In the pandemic…many of us including myself were in a constant state of fight, flight, or freeze.

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The latter nervous system state, freeze, became so dominant that we gave it a new name…languishing.

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Burnout

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In sisters Emily and Amelia Nagoski’s book regarding burnout and the stress cycle, they describe that emotions are like tunnels, they have a beginning, middle, and end.  Unfortunately many of us get stuck in an emotion when we are unable to complete the stress cycle and resolve the emotional state. This can feel like hyper vigilance, languishing, anger, fear, etc.

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The pandemic made it hard, if not impossible, for many of my clients, and myself, to complete the stress response cycle. Among the reasons for this was the difficulty discerning when an emotion started or ended, prolonging completion of the cycle. Additionally, at its height there were no clear explanations for when the pandemic would be over. Even now at the time of this writing, Spring 2022, we continue to have uncertainties about the pandemic’s end. This all served to further heighten the feeling of stress. As a result, I have found it helpful for myself and my clients to seek ways of completing the stress response cycle.

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The strategies used for completing the stress response cycle can assist with improved health and decreased mortality. Employing them serve to make us healthier, mentally and physically.

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Tips for completing the stress cycle:

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1. Move. You may have heard that “Exercise is medicine,” and it’s true. Movement is key for all humans, and helps with completing the stress response cycle. Aerobic exercise in particular is linked to improved cognition, decreases in mental illness, and improvements in concussion recovery outcomes (APA, 2020). Interestingly, it may mimic physiologically stressful situations in the brain and aid in overcoming other stressful situations.
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2. Cry. It’s true! Crying or engaging in time to grieve/feel the emotion is a powerful tool. To move through an emotion, we need to see its end, as the Nagoski sisters discuss in Burnout. In EMDR, we do this by noticing the thoughts, images, body sensations, and emotions that come up with a particular memory. We then follow the channels of association or go down the emotional tunnel until there is no distress in the body.
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3. Connect. Social interaction is also medicine, with potentially even larger implications than exercise! A meta-analysis of social relationships and mortality risk indicates that we should really think about “prescribing” more social interaction, for our clients as well as ourselves. The researchers argued that “People with stronger social relationships had a 50% increased likelihood of survival than those with weaker social relationships.” They further stated that “These findings indicate that the influence of social relationships on the risk of death are comparable with well-established risk factors for mortality such as smoking and alcohol consumption and exceed the influence of other risk factors such as physical inactivity and obesity.” In other words, it’s not only fun to connect with your social network, it’s also really important for your health.” (Holt-Lunstad, J. Smith TB, Layton JB, 2010)

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The myth of closure

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In using the above tools for completing the stress response cycle it may be tempting, and frankly natural, to seek formal closure. Our brains are simple in many ways, and closure gives us permission to move on. If we knew when the collective traumatic experience of Covid-19 would end we could cope with it better. But as I’ve shared before, the end is unknown, though many of us have shifted to thinking of ways to “move on” from this pandemic.

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What I’ve realized is that moving on is not possible. Grief and loss, like trauma recovery, is not about closure, but living with the loss.  Interestingly, many states/countries have adopted this view, now saying that they are  “living with the virus.” But how can they live with the traumas or losses they’ve faced? Believe me I have asked myself this along with similar questions many times in my work as a clinician. Is it possible to have closure after events like:
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• The death of a small child?
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• The loss of a romantic relationship?
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• The loss of an opportunity for a memorial service of a loved one due to Covid?
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• Not having a high school graduation?
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• The atrocities in Ukraine?
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• The killing of George Floyd and others, prompting the continued need for the Black Lives Matter movement?
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• The loss of your sense of self as your cognition has changed after brain injury?
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Will we find closure for these losses? In short, no. But as Pauline Boss (2022) states, “The myth of closure after loss; especially ambiguous losses…is just not possible, nor should it be the goal.”

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Resilience vs. Closure

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In Pauline Boss’s seminal work on ambiguous loss (Boss, 2006), she discusses losses that are not typical or socially scripted.  Her research inspires us to find resilience vs. closure when counseling others through unclear loss like brain injury, dementia, missing people, or loss of roles/jobs.

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In her recent book titled, The Myth of Closure, she talks about how both/and thinking can assist us in holding two truths. For example, we can both embrace the joy in gathering with others again, while also contending with feelings of loss with experiences of the pandemic. In my clinical work I find that allowing space for my clients to have two emotions is also helpful. It is common for brain injury survivors to both feel angry at their injury and a sense of gratitude for the insights they have gained.

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My experiences have shown that while difficult, helping my clients to increase self-compassion in the midst of loss is essential. This is as true for them as it is for each of us. In the words of Mr. Rogers, “Sometimes you feel two feelings at the same time and that’s okay.” This pandemic has been a tough season for us all, clinicians and clients alike, but I encourage you to find room for the gray. Even when our brains and the world wants to tie things up in a tidy bow, rest knowing that closure is not needed but resilience is ever present.

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A Playlist Made With You In Mind
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Listen to these tunes as you sit in the gray, reflect on memories or celebrate the legacy of someone whose light you walk in now. You may want to take in these songs as you process or unpack something. You can listen here.

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